Rhythmic rocking stereotypies in frontal lobe seizures: A quantified video study.

OBJECTIVES

Rhythmic, stereotyped movements occur in some epileptic seizures. We aimed to document time-evolving frequencies of antero-posterior rocking occurring during prefrontal seizures, using a quantitative video analysis.

METHODS

Six seizures from 3 patients with prefrontal epilepsy yet different sublobar localizations were analyzed using a deep learning-based head-tracking method.

RESULTS

Mean rocking frequency varied between patients and seizures (0.37-1.0Hz). Coefficient of variation of frequency was low (≤12%).

DISCUSSION: Regularity of body rocking movements suggests a mechanism involving intrinsic oscillatory generators. Since localization of seizure onset varied within prefrontal cortex across patients, altered dynamics converging on a "final common pathway" of seizure propagation involving cortico-subcortical circuits is hypothesized.